Unilateral or Localized Reinke's Edema (Pseudocyst) as a Manifestation of Vocal Fold Paresis: The Paresis Podule

Background The nosology of free‐edge vocal fold lesions remains imprecise. In particular, the lesion termed pseudocyst remains enigmatic, because its histology is poorly defined and because its etiology is unknown. We define pseudocyst as a discrete, unilateral, localized area of Reinke's edema...

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Veröffentlicht in:The Laryngoscope 2001-04, Vol.111 (4), p.576-580
Hauptverfasser: Koufman, James A., Belafsky, Peter C.
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description Background The nosology of free‐edge vocal fold lesions remains imprecise. In particular, the lesion termed pseudocyst remains enigmatic, because its histology is poorly defined and because its etiology is unknown. We define pseudocyst as a discrete, unilateral, localized area of Reinke's edema (without a capsule), usually occurring at the midportion of the free‐edge striking zone. Objective To report the demographic and clinical findings, as well as discuss our diagnostic and therapeutic strategies, in patients with unilateral Reinke's edema or pseudocyst. Methodology All patients diagnosed with unilateral Reinke's edema or pseudocyst over a 2‐year period (1998–1999) were identified from the clinical database of the Center for Voice Disorders of Wake Forest University, Winston‐Salem, North Carolina. The record of each patient was retrospectively reviewed. Results Thirteen patients were identified, 12 of whom were female. The mean age was 36 years. Sixty‐nine percent (9 of 13) had unilateral pseudocyst and 31% (4 of 13) had unilateral Reinke's edema. All patients had documented vocal fold paresis on laryngeal electromyography. The 9 patients with pseudocyst underwent excision of their lesions; 7 had bilateral medialization laryngoplasties, 1 had lipoinjection, and 3 did not have surgical intervention. Significant improvement was noted postoperatively on a self‐administered glottal insufficiency (symptom) index (P
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In particular, the lesion termed pseudocyst remains enigmatic, because its histology is poorly defined and because its etiology is unknown. We define pseudocyst as a discrete, unilateral, localized area of Reinke's edema (without a capsule), usually occurring at the midportion of the free‐edge striking zone. Objective To report the demographic and clinical findings, as well as discuss our diagnostic and therapeutic strategies, in patients with unilateral Reinke's edema or pseudocyst. Methodology All patients diagnosed with unilateral Reinke's edema or pseudocyst over a 2‐year period (1998–1999) were identified from the clinical database of the Center for Voice Disorders of Wake Forest University, Winston‐Salem, North Carolina. The record of each patient was retrospectively reviewed. Results Thirteen patients were identified, 12 of whom were female. The mean age was 36 years. Sixty‐nine percent (9 of 13) had unilateral pseudocyst and 31% (4 of 13) had unilateral Reinke's edema. All patients had documented vocal fold paresis on laryngeal electromyography. The 9 patients with pseudocyst underwent excision of their lesions; 7 had bilateral medialization laryngoplasties, 1 had lipoinjection, and 3 did not have surgical intervention. Significant improvement was noted postoperatively on a self‐administered glottal insufficiency (symptom) index (P &lt;.001). Conclusion Unilateral Reinke's edema and localized Reinke's edema (pseudocyst) are distinct clinical entities, occurring most frequently in women in their fourth decade. The finding of unilateral Reinke's edema or pseudocyst should alert the clinician to the likelihood of vocal cord paresis. Surgical intervention with medialization laryngoplasty appears to be beneficial.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1097/00005537-200104000-00005</identifier><identifier>PMID: 11359123</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken, NJ: John Wiley &amp; Sons, Inc</publisher><subject>Adult ; Biological and medical sciences ; dysphonia ; Electromyography ; Female ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; hoarseness ; Humans ; Laryngeal Edema - diagnosis ; Laryngeal Edema - etiology ; Laryngeal Edema - surgery ; laryngeal electromyography ; laryngoplasty ; Laryngoscopy ; Male ; Medical sciences ; Non tumoral diseases ; Otorhinolaryngology. Stomatology ; polypoid degeneration ; pseudocyst ; Reinke's edema ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the upper aerodigestive tract ; Terminology as Topic ; thyroplasty ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology ; Vocal Cord Paralysis - complications ; Vocal Cord Paralysis - diagnosis ; Vocal Cord Paralysis - surgery ; vocal fold paresis ; voice disorder</subject><ispartof>The Laryngoscope, 2001-04, Vol.111 (4), p.576-580</ispartof><rights>Copyright © 2001 The Triological Society</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4385-1b4475b110a34eed9a7139be59d10a411231c25330bc8ad3421b30be67d6d64c3</citedby><cites>FETCH-LOGICAL-c4385-1b4475b110a34eed9a7139be59d10a411231c25330bc8ad3421b30be67d6d64c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F00005537-200104000-00005$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F00005537-200104000-00005$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=943841$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11359123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koufman, James A.</creatorcontrib><creatorcontrib>Belafsky, Peter C.</creatorcontrib><title>Unilateral or Localized Reinke's Edema (Pseudocyst) as a Manifestation of Vocal Fold Paresis: The Paresis Podule</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Background The nosology of free‐edge vocal fold lesions remains imprecise. In particular, the lesion termed pseudocyst remains enigmatic, because its histology is poorly defined and because its etiology is unknown. We define pseudocyst as a discrete, unilateral, localized area of Reinke's edema (without a capsule), usually occurring at the midportion of the free‐edge striking zone. Objective To report the demographic and clinical findings, as well as discuss our diagnostic and therapeutic strategies, in patients with unilateral Reinke's edema or pseudocyst. Methodology All patients diagnosed with unilateral Reinke's edema or pseudocyst over a 2‐year period (1998–1999) were identified from the clinical database of the Center for Voice Disorders of Wake Forest University, Winston‐Salem, North Carolina. The record of each patient was retrospectively reviewed. Results Thirteen patients were identified, 12 of whom were female. The mean age was 36 years. Sixty‐nine percent (9 of 13) had unilateral pseudocyst and 31% (4 of 13) had unilateral Reinke's edema. All patients had documented vocal fold paresis on laryngeal electromyography. The 9 patients with pseudocyst underwent excision of their lesions; 7 had bilateral medialization laryngoplasties, 1 had lipoinjection, and 3 did not have surgical intervention. Significant improvement was noted postoperatively on a self‐administered glottal insufficiency (symptom) index (P &lt;.001). Conclusion Unilateral Reinke's edema and localized Reinke's edema (pseudocyst) are distinct clinical entities, occurring most frequently in women in their fourth decade. The finding of unilateral Reinke's edema or pseudocyst should alert the clinician to the likelihood of vocal cord paresis. Surgical intervention with medialization laryngoplasty appears to be beneficial.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>dysphonia</subject><subject>Electromyography</subject><subject>Female</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>hoarseness</subject><subject>Humans</subject><subject>Laryngeal Edema - diagnosis</subject><subject>Laryngeal Edema - etiology</subject><subject>Laryngeal Edema - surgery</subject><subject>laryngeal electromyography</subject><subject>laryngoplasty</subject><subject>Laryngoscopy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Non tumoral diseases</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>polypoid degeneration</subject><subject>pseudocyst</subject><subject>Reinke's edema</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the upper aerodigestive tract</subject><subject>Terminology as Topic</subject><subject>thyroplasty</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><subject>Vocal Cord Paralysis - complications</subject><subject>Vocal Cord Paralysis - diagnosis</subject><subject>Vocal Cord Paralysis - surgery</subject><subject>vocal fold paresis</subject><subject>voice disorder</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE9v1DAQxS0EokvhKyBLSPw5pHhiO064ldKWSktZVW0pJ8uJJ8I0Gy92Ith--nrJdrniiz1Pv3kzfoRQYAfAKvWepSMlV1nOGDCRquyv9IjMQHLIRFXJx2TGWM6zUuY3e-RZjD8Tq7hkT8keAJcV5HxGVle968yAwXTUBzr3jencHVp6ga6_xTeRHltcGvp2EXG0vlnH4R01kRr6xfSuxTiYwfme-pZeb3rpie8sXZiA0cUP9PIHPhR04e3Y4XPypDVdxBfbe59cnRxfHn3O5l9Pz44O51kjeCkzqIVQsgZghgtEWxkFvKpRVjZJAtLy0OSSc1Y3pbFc5FCnNxbKFrYQDd8nryffVfC_xrSnXrrYYNeZHv0YtWKl4IqLBJYT2AQfY8BWr4JbmrDWwPQmbf2Qtt6lPUmp9eV2xlgv0f5r3MabgFdbwMQUThtM37i446r0VQGJ-jRRv12H6_8er-eHF9-lTFls1M022WTj4oB_djYm3OpCcSX1t_NTffPxuiiBgT7n96Wepuc</recordid><startdate>200104</startdate><enddate>200104</enddate><creator>Koufman, James A.</creator><creator>Belafsky, Peter C.</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200104</creationdate><title>Unilateral or Localized Reinke's Edema (Pseudocyst) as a Manifestation of Vocal Fold Paresis: The Paresis Podule</title><author>Koufman, James A. ; Belafsky, Peter C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4385-1b4475b110a34eed9a7139be59d10a411231c25330bc8ad3421b30be67d6d64c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>dysphonia</topic><topic>Electromyography</topic><topic>Female</topic><topic>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>hoarseness</topic><topic>Humans</topic><topic>Laryngeal Edema - diagnosis</topic><topic>Laryngeal Edema - etiology</topic><topic>Laryngeal Edema - surgery</topic><topic>laryngeal electromyography</topic><topic>laryngoplasty</topic><topic>Laryngoscopy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Non tumoral diseases</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>polypoid degeneration</topic><topic>pseudocyst</topic><topic>Reinke's edema</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the upper aerodigestive tract</topic><topic>Terminology as Topic</topic><topic>thyroplasty</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><topic>Vocal Cord Paralysis - complications</topic><topic>Vocal Cord Paralysis - diagnosis</topic><topic>Vocal Cord Paralysis - surgery</topic><topic>vocal fold paresis</topic><topic>voice disorder</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koufman, James A.</creatorcontrib><creatorcontrib>Belafsky, Peter C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koufman, James A.</au><au>Belafsky, Peter C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unilateral or Localized Reinke's Edema (Pseudocyst) as a Manifestation of Vocal Fold Paresis: The Paresis Podule</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2001-04</date><risdate>2001</risdate><volume>111</volume><issue>4</issue><spage>576</spage><epage>580</epage><pages>576-580</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Background The nosology of free‐edge vocal fold lesions remains imprecise. In particular, the lesion termed pseudocyst remains enigmatic, because its histology is poorly defined and because its etiology is unknown. We define pseudocyst as a discrete, unilateral, localized area of Reinke's edema (without a capsule), usually occurring at the midportion of the free‐edge striking zone. Objective To report the demographic and clinical findings, as well as discuss our diagnostic and therapeutic strategies, in patients with unilateral Reinke's edema or pseudocyst. Methodology All patients diagnosed with unilateral Reinke's edema or pseudocyst over a 2‐year period (1998–1999) were identified from the clinical database of the Center for Voice Disorders of Wake Forest University, Winston‐Salem, North Carolina. The record of each patient was retrospectively reviewed. Results Thirteen patients were identified, 12 of whom were female. The mean age was 36 years. Sixty‐nine percent (9 of 13) had unilateral pseudocyst and 31% (4 of 13) had unilateral Reinke's edema. All patients had documented vocal fold paresis on laryngeal electromyography. The 9 patients with pseudocyst underwent excision of their lesions; 7 had bilateral medialization laryngoplasties, 1 had lipoinjection, and 3 did not have surgical intervention. Significant improvement was noted postoperatively on a self‐administered glottal insufficiency (symptom) index (P &lt;.001). Conclusion Unilateral Reinke's edema and localized Reinke's edema (pseudocyst) are distinct clinical entities, occurring most frequently in women in their fourth decade. The finding of unilateral Reinke's edema or pseudocyst should alert the clinician to the likelihood of vocal cord paresis. Surgical intervention with medialization laryngoplasty appears to be beneficial.</abstract><cop>Hoboken, NJ</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>11359123</pmid><doi>10.1097/00005537-200104000-00005</doi><tpages>5</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete; Access via Wiley Online Library
subjects Adult
Biological and medical sciences
dysphonia
Electromyography
Female
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
hoarseness
Humans
Laryngeal Edema - diagnosis
Laryngeal Edema - etiology
Laryngeal Edema - surgery
laryngeal electromyography
laryngoplasty
Laryngoscopy
Male
Medical sciences
Non tumoral diseases
Otorhinolaryngology. Stomatology
polypoid degeneration
pseudocyst
Reinke's edema
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the upper aerodigestive tract
Terminology as Topic
thyroplasty
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Vocal Cord Paralysis - complications
Vocal Cord Paralysis - diagnosis
Vocal Cord Paralysis - surgery
vocal fold paresis
voice disorder
title Unilateral or Localized Reinke's Edema (Pseudocyst) as a Manifestation of Vocal Fold Paresis: The Paresis Podule
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